Isidro M Bulatao MD PC

Primary specialty

Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X

License

097438 Issued in NY

Legal business name

ISIDRO M BULATAO MD PC

Practice address

190 5TH Ave
Troy, NY 12180

Phone

(518) 235-3990

Fax

(518) 235-9177

NPI assigned

Apr 16, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Isidro M Bulatao, MD

Title

President

Phone

(518) 235-3990

Specialties & licenses 1

Addresses

Other identifiers 3

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1176681600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1851516785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 986",
            "city": "LATHAM",
            "state": "NY",
            "postal_code": "12110",
            "telephone_number": "518-235-3990",
            "fax_number": "518-235-9177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "190 5TH AVE",
            "city": "TROY",
            "state": "NY",
            "postal_code": "12180",
            "telephone_number": "518-235-3990",
            "fax_number": "518-235-9177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ISIDRO M BULATAO MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-16",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BULATAO",
        "authorized_official_first_name": "ISIDRO",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "518-235-3990",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "NY",
            "license": "097438",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CDPHP",
            "identifier": "10000230",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "20365",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00529300",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician in Troy, NY
• Providers in Troy, NY by specialty
• Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.